Australia is getting older. That is a success story - more people are surviving into later life - but it also changes the health challenge. The aim cannot be longevity alone. It has to include healthspan: maintaining physical capacity, cognition, social connection and independence while preventing or managing chronic disease as effectively as possible.
Primary source: Australian Institute of Health and Welfare, Australia's health 2026.
The Australian picture
Australia's Health 2026 reports that 18% of the population was aged 65 or over in 2024-25, up from 8.9% in 1975-76. The proportion is projected to reach 24% by 2065-66.[1]
The number of people aged 65 and over is projected to double from 4.8 million in 2024-25 to 9.7 million in 2065-66, while the population aged 85 and over is projected to triple from 603,000 to 1.9 million.[1]
Australians are also living longer: life expectancy at birth in 2022-2024 was 81.1 years for males and 85.1 years for females. But AIHW notes that between 2003 and 2024, average time spent in ill health also increased by 1.2 years for males and 1.5 years for females.[1]
Ageing changes the physiology - but decline is not uniform
Ageing is associated with changes in muscle mass, bone, balance, cardiovascular function, kidney function, hearing, vision, sleep and the way medicines are handled. But the rate and impact of those changes vary enormously between individuals.
AIHW reports that 94% of Australians aged 85 and over were living with at least one chronic condition. Multimorbidity can increasingly affect mobility, cognition and independence and create more complex care needs.[1]
That makes prevention and function-preservation increasingly important, even when chronic disease is already present.
Healthy ageing is multi-system
A useful healthy-ageing plan looks beyond a single diagnosis or a single number on the scale. It asks what capacities allow the person to remain independent and engaged.
| Domain | Why it matters | Useful measures or checks |
|---|---|---|
| Muscle & strength | Strength supports mobility, glucose use, bone loading and the ability to perform daily tasks. | Resistance exercise, functional strength, weight/lean-mass trend and protein adequacy. |
| Balance & mobility | Falls can rapidly reduce independence and confidence. | Fall history, gait, balance, footwear, vision and home hazards. |
| Cardiovascular & metabolic health | Blood pressure, lipids and glucose influence stroke, heart disease, kidney disease and brain health. | BP, lipids, HbA1c/glucose, kidney function and overall cardiovascular-risk review. |
| Brain health | Cognition is influenced by vascular health, hearing, vision, sleep, mood and social engagement. | Memory/function changes, hearing/vision checks, sleep and cognitive assessment when indicated. |
| Nutrition | Older adults can be vulnerable to undernutrition, loss of appetite and muscle loss as well as excess weight. | Diet pattern, protein intake, weight change, appetite and targeted nutrient assessment. |
| Sleep | Poor sleep and sleep apnoea can worsen daytime function, blood pressure, mood and cognition. | Sleep quality, snoring/apnoea clues and daytime sleepiness. |
| Medicines | Multiple chronic conditions often mean multiple medicines, with greater risk of interactions and side effects. | Current medicine list, kidney function, falls/dizziness, pharmacist or medical review. |
| Social connection & purpose | Isolation can affect mental health, activity, cognition and quality of life. | Regular contact, meaningful activity, transport, community participation and support. |
Strength and balance are not optional extras
The 2026 Australian movement guidelines recommend adults undertake muscle-strengthening activity on at least two days per week and functional activities for mobility, balance and coordination on at least three days per week, alongside regular aerobic and light activity.[2]
For older adults, these capacities can be the difference between independence and needing assistance. Exercise should be adapted to current health, mobility and fall risk.
Falls, hearing and vision deserve routine attention
Healthdirect notes that adults over 65 may have their falls risk assessed regularly, particularly after a fall, and that exercises can help reduce fall risk. It also recommends attention to vision and hearing.[3]
Hearing and vision are not merely sensory issues. They affect communication, balance, confidence, social engagement and cognitive load. Dementia Australia includes untreated hearing impairment and vision loss among modifiable dementia risk factors.[4]
What is worth measuring?
A healthy-ageing dashboard should focus on function and change over time rather than collecting every possible number.
- Strength and function: ability to rise from a chair, climb stairs, carry groceries and complete daily tasks.
- Mobility and falls: gait, balance, falls history, fear of falling and need for mobility aids.
- Body composition: unintentional weight loss, waist, lean-mass trend and signs of frailty.
- Cardiovascular/metabolic markers: blood pressure, lipids, glucose and kidney function as clinically appropriate.
- Nutrition: appetite, protein and overall diet quality, swallowing or dental problems and targeted deficiency testing when indicated.
- Hearing and vision: regular checks and use of prescribed aids.
- Cognition and mood: changes in memory, executive function, depression, anxiety and social engagement.
- Medication burden: current list, side effects, adherence, interactions and whether a review is due.
- Sleep: duration, quality, apnoea risk and daytime function.
Healthspan means keeping reserve
A resilient older person has enough physical and cognitive reserve to cope with illness, surgery, travel, a fall or a short period of inactivity without losing large amounts of function.
That reserve is built gradually through strength, fitness, nutrition, sleep, social participation, preventive health care and appropriate management of chronic disease.
The goal is not to avoid ageing. It is to arrive at later life with as much capacity as possible.
Questions worth asking
A physiology-first healthy-ageing conversation can include:
- Am I preserving strength and muscle, or only watching my body weight?
- Have my balance, mobility or falls risk changed over the past year?
- Are hearing, vision and dental health being maintained?
- Are my blood pressure, glucose, cholesterol and kidney function appropriately monitored?
- Am I eating enough protein and nutritious food to support muscle and recovery?
- Is poor sleep or sleep apnoea affecting cognition, blood pressure or daytime function?
- Do all my medicines still have a clear role, and has my regimen been reviewed recently?
- Am I maintaining social connection, purpose and activities that challenge both body and mind?
Are we simply adding years to life, or deliberately preserving the physiology that makes those years independent and worth living?
When professional assessment matters
Unintentional weight loss, repeated falls, new weakness, progressive memory change, worsening breathlessness, recurrent dizziness, swallowing difficulty, marked loss of function or increasing difficulty managing medicines should prompt professional assessment.
Healthy ageing often works best as coordinated care involving the GP and, where appropriate, physiotherapy, exercise physiology, dietetics, pharmacy, audiology, optometry and specialist services.
The Physiology First takeaway
Healthy ageing is the point where all the previous Physiology First themes meet: metabolism, cardiovascular health, nutrition, sleep, movement, brain health, stress and medicines.
The most useful goal is not a perfect set of numbers. It is preserving enough physiological reserve to remain mobile, cognitively engaged, socially connected and as independent as possible - then measuring what changes as we age.
KNOW MEASURE UNDERSTAND CONNECT QUESTION OPTIMISE RE-MEASURE
[1] Australian Institute of Health and Welfare (2026). Australia's health 2026. Australian Government. https://www.aihw.gov.au/reports/australias-health/australias-health-2026
[2] Australian Government Department of Health, Disability and Ageing. 24-hour movement guidelines for all Australians. https://www.health.gov.au/topics/physical-activity/24-hour-movement-guidelines-for-all-australians
[3] Healthdirect Australia. Manage your health in your 60s. https://www.healthdirect.gov.au/manage-your-health-in-your-60s
[4] Dementia Australia. Risk factors for developing dementia. https://www.dementia.org.au/brain-health/risk-factors-developing-dementia
[5] Healthdirect Australia. Medicines safety for older people. https://www.healthdirect.gov.au/medicines-safety-for-older-people
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